Surgical treatment and fertility perservation in endometrial cancer

Radiol Oncol. 2021 Feb 11;55(2):144-149. doi: 10.2478/raon-2021-0009.

Abstract

Background: Endometrial cancer (EC) represents a high health burden in Slovenia and worldwide. The incidence is increasing due to lifestyle and behavioural risk factors such as obesity, smoking, oestrogen exposure and aging of the population. In many cases, endometrial cancer is diagnosed at an early stage due to obvious signs and symptoms. The standard treatment is surgery with or without adjuvant therapy, depending on the stage of the disease and the risk of recurrence. However, treatment modalities have changed in the last decades, considerably in the extent of lymphadenectomy.

Conclusions: The gold standard of treatment for is surgery, which may be the only treatment modality in the early stages of low-grade tumours. In recent years, a minimally invasive approach with sentinel node biopsy (SNB) has been proposed. A conservative approach with hormonal treatment is used if fertility preservation is desired. If EC is in advance stage, high-risk histology, or high grade, radiotherapy, chemotherapy, or a combination of both is recommended.

Keywords: endometrial cancer; laparoscopy; minimally invasive surgery; treatment; uterus.

MeSH terms

  • Conservative Treatment / methods
  • Contraceptives, Oral, Hormonal / therapeutic use
  • Endometrial Neoplasms / etiology
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / surgery*
  • Endometrial Neoplasms / therapy
  • Female
  • Fertility Preservation / methods*
  • Genetic Predisposition to Disease
  • Humans
  • Lymph Node Excision
  • Neoplasm Grading
  • Radiotherapy, Adjuvant
  • Risk Factors
  • Sentinel Lymph Node Biopsy
  • Slovenia

Substances

  • Contraceptives, Oral, Hormonal